{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T18:00:25Z","timestamp":1778608825586,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p><jats:italic>Background.<\/jats:italic>Patients who undergo high-risk surgery represent a large amount of post-operative ICU-admissions. These patients are at high risk of experiencing postoperative complications. Renal Resistive Index was found to be related with renal dysfunction, hypertension, and posttraumatic hemorrhagic shock, probably due to vasoconstriction. We explored whether Renal Resistive Index (RRI), measured after awakening from general anesthesia, could have any relationship with postoperative complications.<jats:italic>Methods.<\/jats:italic>In our observational, stratified dual-center trial, we enrolled patients who underwent general anesthesia for high-risk major surgery. After awakening in recovery room (or during awakening period in subjects submitted to cardiac surgery) we measured RRI by echo-color-Doppler method. Primary endpoint was the association of altered RRI (&gt;0.70) and outcome during the first postoperative week.<jats:italic>Results.<\/jats:italic>205 patients were enrolled: 60 (29.3%) showed RRI &gt; 0.70. The total rate of adverse event was 27 (18.6%) in RRI \u2264 0.7 group and 19 (31.7%) in RRI &gt; 0.7 group (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.04<\/mml:mn><mml:mn>2<\/mml:mn><\/mml:math>). Significant correlation between RRI &gt; 0.70 and complications resulted in pneumonia (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.016<\/mml:mn><\/mml:math>), septic shock (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.003<\/mml:mn><\/mml:math>), and acute renal failure (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.00<\/mml:mn><mml:mn>1<\/mml:mn><\/mml:math>) subgroups. Patients with RRI &gt; 0.7 showed longer ICU stay (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0<\/mml:mn><mml:mo>.<\/mml:mo><mml:mn>001<\/mml:mn><\/mml:math>) and lasting of mechanical ventilation (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.004<\/mml:mn><\/mml:math>). These results were confirmed in cardiothoracic surgery subgroup. RRI &gt; 0.7 duplicates triplicates the risk of complications, both in general (OR 2.03 93 95% CI 1.02\u20134.02,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.044<\/mml:mn><\/mml:math>) and in cardiothoracic (OR 2.62 95% CI 1.11\u20136.16,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.027<\/mml:mn><\/mml:math>) population. Furthermore, we found RRI &gt; 0.70 was associated with a triplicate risk of postoperative septic shock (OR 3.04, CI 95% 1.5\u20137.01;<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.002<\/mml:mn><\/mml:math>).<\/jats:p>","DOI":"10.1155\/2014\/917985","type":"journal-article","created":{"date-parts":[[2014,5,20]],"date-time":"2014-05-20T17:20:47Z","timestamp":1400606447000},"page":"1-6","source":"Crossref","is-referenced-by-count":15,"title":["May Renal Resistive Index Be an Early Predictive Tool of Postoperative Complications in Major Surgery? Preliminary Results"],"prefix":"10.1155","volume":"2014","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6649-1752","authenticated-orcid":true,"given":"Enrico","family":"Giustiniano","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care Unit, Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano (Milano), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Meco","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Anesthesia Unit, Sant\u2019Ambrogio Clinical Institute, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0254-3143","authenticated-orcid":true,"given":"Emanuela","family":"Morenghi","sequence":"additional","affiliation":[{"name":"Biostatistic Unit, Humanitas Research Hospital, Rozzano (Milano), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Ruggieri","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Unit, Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano (Milano), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Cosseta","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Anesthesia Unit, Sant\u2019Ambrogio Clinical Institute, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Cirri","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Anesthesia Unit, Sant\u2019Ambrogio Clinical Institute, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0307-3136","authenticated-orcid":true,"given":"Orazio","family":"Difrancesco","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Unit, Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano (Milano), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola Cosma","family":"Zito","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Unit, Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano (Milano), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yari","family":"Gollo","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Unit, Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano (Milano), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferdinando","family":"Raimondi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Unit, Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano (Milano), 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